Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures

Devkota, Pramod; Khan, Javed; Shrestha, Suman Kumar; Acharya, Balakrishnan M; Pradhan, Nabeesman S.; Mainali, Laxmi P; Khadka, Padam B; Manandhar, Hemanta K.

doi:10.1177/230949901402200306

Cited by 17 publications

(13 citation statements)

References 25 publications

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“…The MIPO technique has gained popularity recently because of its satisfactory clinical outcomes123456789101112. This method minimizes disruption of soft tissue and preserves the blood supply to the fracture site.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate

Xue

Ding

et al. 2016

Sci Rep

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Minimally invasive plate osteosynthesis (MIPO) has been widely accepted because of its satisfactory clinical outcomes. However, the implant construct that works best for MIPO remains controversial. Different plate designs result in different influence mechanisms to blood flow. In this study, we created ulnar fractures in 42 beagle dogs and fixed the fractures using MIPO. The dogs were randomly divided into two groups and were fixed with a limited contact dynamic compression plate (LC-DCP) or a locking compression plate (LCP). Our study showed that with MIPO, there was no significant difference between the LCP and the LC-DCP in terms of fracture fixation, bone formation, or mineralization. Combined with the previous literature, we inferred that the healing process is affected by the quality of fracture reduction more than plate selection.

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Section: Discussionmentioning

confidence: 99%

“…Minimally invasive plate osteosynthesis (MIPO) has gained popularity because it minimizes dissection of broken bone fragments and therefore preserves vascularity and increases the healing potential123456789101112. It provides adequate stability and is a safe, effective method for both comminuted and simple fractures6111314.…”

mentioning

confidence: 99%

Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate

Xue

Ding

et al. 2016

Sci Rep

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“…With the development of minimally invasive technology, minimally invasive plate osteosynthesis (MIPO) has become an excellent method. It protected the subcutaneous soft tissue of anterior medial tibia and enabled adequate soft tissue coverage overlying the plate with less wound complications.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Nailing Versus Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures: A Systematic Review and Meta‐Analysis

Liu

Xue

et al. 2019

Orthopaedic Surgery

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To evaluate the application, safety and efficacy of the patients treated with intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) in distal tibia fractures. Following the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines, we searched databases PubMed, Cochrane library, EMBASE and Web of Science from inception of the database up to 10 October 2018, using the keywords “distal tibia fractures”, “plate”, “intramedullary nailing” and “RCT” to identify randomized clinical trials about distal tibia fractures. The included studies were assessed by two researchers according to the Cochrane risk‐of‐bias criteria. The primary outcome of measurement included operation time, malunion rate, nonunion/delayed union rate, and wound complication. Data analysis was conducted with Review Manager 5.3 software. A total of 10 RCTs involving 911 patients fulfilled the inclusion criteria with 455 patients in the IMN group and 456 patients in the MIPO group. There were no significant differences in radiation time, nonunion or delayed union rate, union time and operation time between the two groups. Patients treated with MIPO had lower incidence of malunion compared with IMN (RR = 1.85, 95%CI: 1.21 to 2.83, P = 1.00), while IMN seemed to have lower surgical incision complications whether in closed or opening fractures (RR = 0.49, 95%CI 0.33 to 0.73, P = 0.43). But in patients classified as 43A, the result of subgroup analysis suggested that there was no significant inwound complication between the two groups. MIPO was superior in preventing malunion compared with IMN, and intramedullary nailing appeared to have lower wound complications. However, in patients with 43A distal tibial fractures, MIPO was more recommended for its prevention of malunion. No matter which method we choose, we should notice and prevent the associated complications.

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“…This was comparable to a study by Devkota et al, which also showed similar operative times. 15 The mean blood loss during the surgery for distal tibial fracture using minimally invasive plate osteosynthesis was 75 ml which is significantly less compared to the traditional open reduction internal fixation with plates. This is possibly due to the smaller incisions and non-usage of negative suction drains in cases of MIPO for distal tibial fractures.…”

Section: Resultsmentioning

confidence: 96%

Functional outcome of minimally invasive plate osteosynthesis with the use of locking plate in fracture distal end of tibia

et al. 2020

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Background : Distal tibia fractures or pilon fractures are usually the result of combined compressive and shearing forces, which may lead to instability of the metaphysis. Poor vascularity, lack of muscle cover and frequent intra-articular extension often make these fractures very challenging to manage. There are plenty of options available to treat a distal tibia fracture which includes intramedullary nailing, external fixation, open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO). The aim of this study was to evaluate the results of MIPO with respect to the healing of fracture site, the incidences of complications and to conclude whether MIPO circumvents the problems of formal open reduction and fixation with other implants.Methods: A series of forty patients with fracture of the distal tibia on preoperative X-rays were treated with minimally invasive plate osteosynthesis using pre-contoured locking plates from June 2014 to October 2018 and followed up at regular intervals with X-rays and monitoring for complications.Result: The functional scores were evaluated using Teeny and Wiss clinical rating system for ankle joints. Thirty-two patients had an ‘Excellent’ or ‘Good’ outcome. One patient was diagnosed with a soft tissue complication and delayed union and 3 patients were diagnosed with malunion without significant functional disability at follow up. Conclusion: Minimally invasive plate osteosynthesis with pre-contoured locking plates is associated with high union rate and good functional outcomes. It is an effective treatment modality for distal tibia fractures.

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Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures

Cited by 17 publications

References 25 publications

Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate

Comparison of the effect on bone healing process of different implants used in minimally invasive plate osteosynthesis: limited contact dynamic compression plate versus locking compression plate

Intramedullary Nailing Versus Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures: A Systematic Review and Meta‐Analysis

Functional outcome of minimally invasive plate osteosynthesis with the use of locking plate in fracture distal end of tibia

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